Breaking Up with OCD: Avoiding Common Treatment Barriers

Breaking Up with OCD: Avoiding Common Treatment Barriers

It takes a lot of guts for patients to make the decision to break up with obsessive-compulsive disorder. They have been living many years with tormenting thoughts and fears, dictating how they go about their days. When your patient is on board with breaking up with their OCD, you want to encourage them not to DRIFT away from OCD, but rather to look forward to how they want to live in the future, and to break up with OCD. Exposure and response prevention (ERP) is the gold standard for treating OCD. [1] The procedure is simple, but the task of breaking up is always emotionally difficult. Let’s examine the DRIFT treatment barriers (my made-up acronym) so we can support our patients in officially kissing OCD goodbye. OCD is a complicated disorder that includes intrusive thoughts, images, and urges that cause people to feel extreme distress, anxiety, disgust, and/or fear. [2] Many recognize that these thoughts are illogical. In order to cope with the distress, people generally use compulsions to reduce the experienced distress. These take the form of rituals, reassurance questions, neutralization, and avoidance behaviors. [2] Over time, compulsions become tightly linked to the initial fear, and behaviors are performed nearly instantaneously. Colloquially, some patients have...
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The Semi-Structured Intake: How to Get Everything You Need in Your First Meeting

The Semi-Structured Intake: How to Get Everything You Need in Your First Meeting

As you and your cohort settle into practicum, you will hear at some point about the intake process, specifically how different sites may have different ways of approaching an intake. Department of Mental Health sites in your county may have an intake form with questions that go on for several pages. For example, the Los Angeles County Department of Mental Health Adult Intake form has nine sections, with subsection questions for each one!

However, if you find yourself in a site that allows you freedom to conduct a semi-structured intake, it may still be challenging to find the balance between having an organic session with the client while obtaining relevant information that can inform your treatment plan.


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When the One You Love Abuses Substances: Four Must-Have Boundaries

When the One You Love Abuses Substances: Four Must-Have Boundaries

If you or your clients love someone who abuses substances, you may find yourself with a lot of decisions to make — including whether to continue in the relationship. While you’re making these decisions, having boundaries are like having lines in the sand. Although you get to choose where to draw the line, once it’s crossed, you need to act. Mastering boundaries is a skill that needs and deserves consistent practice. And in the end, it is up to you. These are four boundaries that can be helpful whether you stay in or leave the relationship. Here we go.


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Psychodynamic Therapy 101: An Introduction

Psychodynamic Therapy 101: An Introduction

A new client recently asked me where I would be traveling for an upcoming trip as we looked at our schedules to make her next appointment. When she expressed further curiosity about the conference I would be attending, I explained that it was an annual conference of the society for psychoanalysis and psychoanalytic psychology. A fairly surprised look appeared on her face, and she questioned, “like Freud?”

I readily picked up on her discomfort with the thought of psychoanalysis or being psychoanalyzed. I clarified that she was not meeting with me for psychoanalysis and offered some explanation of basic psychodynamic principles and how these applied to our initial goals for therapy. She seemed to accept my explanation, but mostly just seemed glad to know she wasn’t meeting for psychoanalysis.

Psychodynamic therapy is one of several approaches to therapy used today. However, it is often misunderstood and dismissed as an outmoded approach or historical artifact. It is also often misrepresented in popular culture and sometimes seen as irrelevant to the quick-fix demands of the public and the limitations of insurance.


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Supervision: The Open Door Policy

Supervision: The Open Door Policy

Supervisors are central to training in graduate school, and every supervisor has their own style. Some supervisors prefer a hands-off approach and expect a trainee to take the lead in raising concerns. Other supervisors are much more hands-on and provide detailed feedback on a regular basis. Others may vary in terms of focus, with some supervisors most concerned about teaching particular approaches and some more interested in your own ideas about theory, or your growth from a developmental perspective. Some supervisors are formal and task-oriented, while others are less formal and open-ended.

Of course, supervisors are also different in regards to availability, and approaching a supervisor can be fairly anxiety provoking. After all, supervisors play a key role in your evaluations and overall success in graduate school. Here are a few things to consider in making the most out of your supervisory experience with any type of supervisor.


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5 Tips for Nailing the Intake Process

5 Tips for Nailing the Intake Process

Meeting with a client for a first-time appointment or an intake assessment can be quite overwhelming – especially as a trainee! Only having 60 minutes to obtain all of the information you need is often challenging and sometimes even feels impossible.

However, I encourage you to think of the intake assessment as both a skill and an art; a skill and an art that can be honed through practice and by implementing the tips offered below. Rest assured that by the time you begin your career as a psychologist, intakes will flow fairly routinely and may not even take a full hour to complete.


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Is Religion Welcome in Current Clinical Practice?

Is Religion Welcome in Current Clinical Practice?

In the early history of psychotherapy, research on integrating faith and spirituality did not arouse much interest [1]. However, this attitude has changed in the latter part of the 20th century and the beginning of the 21st century. Psychology has, of late, experienced a paradigm shift with an increased openness to religion and spirituality [2]. This paradigm shift refers to the significant change in historical practices in science [3]. It is suggested that counselors, when building a therapeutic alliance with clients, explore and encourage spiritual expression at the client’s discretion. Current research also suggests individuals with a religious and/or spiritual worldview typically find comfort in their religious or spiritual beliefs and practices during times of un¬certainty or crisis.


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5 Tips for Acing Your First IEP Meeting

5 Tips for Acing Your First IEP Meeting

As a private practice psychologist who specializes in educational consultation and school-based behavioral health, I have sat in on hundreds of IEP meetings.

Students and interns in school-based settings often play an essential role in IEP (Individualized Education Plan) meetings. Many trainees are supervised in administering, interpreting, and reporting on psychological assessment data – which can be quite an intimidating task for new student psychologists.


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Adverse childhood experiences: Traumas that set the framework for life

Adverse childhood experiences: Traumas that set the framework for life

Growing up in a home with physical abuse, emotional neglect, mental illness, alcohol use, or drug use are some examples of childhood adversities. The seminal work of Dr. Vincent Felitti and colleagues asked over 17,000 adults to answer questions about adverse childhood experiences — or ACEs — and current health [1]. Results were shocking: More ACEs led to poorer health in adulthood and early death.

It is important to understand that ACEs do not directly cause poor outcomes; there are likely many mediating mechanisms such as maladaptive coping, unhealthy interpersonal relationships, negative health behaviors, dysfunctional thinking styles, and insecure attachments that contribute to these outcomes. In addition to prevention efforts, these are all potential areas that therapists can intervene to mitigate the long-term effects of adversity.


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Breaking Mental Health Stigma Among Ethnic Minority Clients

Breaking Mental Health Stigma Among Ethnic Minority Clients

Mental health stigma in ethnic minority communities can create critical barriers to treatment for groups including African Americans, Latinx Americans, Native Americans, and Asian Americans. One of the primary contributors to disparities in mental health treatment is mental health stigma, which refers to a collection of negative attitudes, thoughts, behaviors, or beliefs that help to facilitate fear, rejection, and discrimination against people with mental illness1.


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